CLINTON HIGH SCHOOL VOLLEYBALL CAMP PERMISSION SLIP FORM

In consideration of the camp fee being given the privilege of my child participating in the Clinton Arrow Volleyball Day Camp for Girls, I, the undersigned, hereby agree to release and discharge the Clinton Public School District, the Board of Trustees and the Superintendent of the Clinton Public School District, Clinton High School, all employees, agents and staff of the Clinton Public School District, Coach Melissa Denson, and all persons connected with the Clinton Arrow Volleyball Day Camp, on behalf of myself, my child, my heirs, assigns, personal representative and estate as follows:
PARENT/GUARDIAN RELEASE AND ASSUMPTION OF RISK, STATEMENT, & CONSENT FORM
The undersigned parent/guardian certifies that my child is physically fit to participate in this non-contact volleyball day camp. I, the undersigned parent/guardian understand that the camper will engage in physical activity during the program that contains inherent risk and by signing this form, I, the parent or guardian, do hereby release, forever discharge and agree to defend, hold harmless, and indemnify the Clinton Public School District, the Board of Trustees and the Superintendent of the Clinton Public School District, Clinton High School, all employees, agents and staff of the Clinton Public School District, Coach Melissa Denson, and all persons connected with the Clinton Arrow Volleyball Day Camp (collectively referred to as the “CPSD Volleyball Camp”) from any and all negligence claims, liability claims, demands, actions or rights of action, or medical claims that my child or I might incur or which are related to, arise out of, or are in any way connected with my child’s participation in this activity, including those allegedly attributable to the negligent acts or omissions of the CPSD Volleyball Camp while in attendance at said camp. I expressly agree and promise to assume all of the risks existing in the CPSD Volleyball Camp.
While this is a non-contact camp, and while the camp will follow Clinton High School Volleyball Team hydration policies (hydration before start of the day’s exercises, hydration at breaks, and water at-will), the camp will be conducted indoors and the negligence claims, liability claims, demands, actions or rights of action, and medical claims being released, and the risks being assumed, include without limitation those arising from exposure to and exercise and exertion in heat, humidity and the elements (such as heat exhaustion, heat stroke, heart attack, injury, aggravation of known or unknown medical conditions, death, emotional distress, damage to property, or damage to third parties, injuries due to over-exertion, and muscle strain), joint and bone injuries or injuries from being unintentionally struck with a volleyball. I understand that the CPSD Volleyball Camp will not be attended by medical personnel.
I certify that I have for my child, and will maintain at all times while my child is participating in the activities, active health, accident and liability insurance to cover any bodily injury or property damage that my child may suffer while participating in these activities, or else I agree to bear the costs of such injury or damage myself. Should the CPSD Volleyball Camp, or anyone acting on its behalf, incur attorneys’ fees and costs to enforce this agreement, I agree to indemnify and reimburse them for such fees and costs. The CPSD Volleyball Camp, Coach Denson and her staff have my permission to seek medical attention for my child should the need arise, and I agree to indemnify and hold harmless the CPSD Volleyball Camp for any costs to treat my child, even if a representative or agent of the CPSD Volleyball Camp has signed hospital documentation promising to pay for the treatment. / Initial
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By signing this document, I agree and acknowledge that if anyone (including myself and my child) is hurt or property is damaged during my child’s participation in this activity, I will have no right to make a claim or file a lawsuit against the CPSD Volleyball Camp (as defined herein), its agents, sponsors, participants, directors, employees, or any other person or entity acting in any capacity on behalf of the CPSD Volleyball Camp, even if they or any of them negligently caused such injury or damage. My child’s participation is purely voluntary. / Initial__ __
My signature below indicates that I have had sufficient opportunity to read this document, that I have read it, that I understand it, that I understand it affects my legal rights, and that I agree to be bound by its terms.
(Signature of Parent): ______
(Signature of Participant): ______/ Initial_____
NOTICE: THIS IS A LEGAL DOCUMENT. BY SIGNING YOU WAIVE CERTAIN LEGAL RIGHTS. PLEASE READ CAREFULLY. IF YOU HAVE ANY QUESTIONS ABOUT THIS AGREEMENT, PLEASE CONSULT AN ATTORNEY BEFORE YOU SIGN IT. / Initial
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